Chemo Round 3 + A Letter to My CrossFitters from your Favorite Breast Cancer Patient

Here is a photo of the alien coming out of
my skin (aka the port).

Prelude to Round 3: Port Surgery
Each time I go in for chemotherapy, I have to get lab work done so they can review my white blood cell counts to make sure they are high enough to go for another round without added risk of infection, and look at other indicators like red blood cell counts. On round 2, we were going in for labs and instead of the usual 15-20 minutes of getting the IV and the blood draws, it took a whole hour to find a suitable vein. They claim my veins are "smart" because they know to avoid the needles, but in reality they are just a pain because it meant getting poked 3 different times in 3 different areas, leaving me bruised and battered all over my left arm.

At that time, they recommended I get a port, which is an alien-like device placed under the skin in my upper left chest area, with a direct line to my jugular vein. They can stick needles into the port and always find a good vein, and it only takes about 1 minute to get it done. The surgery was an outpatient procedure, performed by the same surgeon who did my mastectomy (a good-natured fellow, Dr. Ed Nelson) who promised he would keep his hand steady when he cut into the jugular vein. How reassuring. The port proved to be a tremendous benefit when I went in for the labs on Round 3, taking just a couple of minutes and leaving me with no additional needle pokes on my ravaged arm.

Round 3: December 17
Then on Tuesday I went in for round 3 of chemotherapy, out of a total of 8 rounds that I have scheduled. On round 5 we switch up the meds, so this was actually 75% of the way through my current chemo medications. I've come to the conclusion that I am either:

(1) Very lucky to escape most of the bad side effects, or
(3) Genetically awesome when it comes to resisting chemo side effects
(Honestly I don't care which it is, I'll take either)

Here is my best shaved-head selfie. I'm really
not that good at taking selfies.

I have had some nausea, but it's easy to control with the medication they give me, and the only other noticeable side effects have been some heartburn (also easy to control with a prescription), and some fatigue (easy to control by sleeping more and skipping work).

I did find out in this most recent lab work that I am slightly anemic, which means I have lower-than-optimal red blood cell count, and also explains why I have been so winded when I go back to workout at CrossFit (it can't be that I took 2 months off and have been eating a terrible diet around the holidays, can it? Nah, I'm sure it's the anemia).

Overall, rounds 2 and 3 have so far been very similar to round 1. I did begin losing some of my hair after round 2, and promptly shaved my head. Of course, as soon as I shaved it, the hair stopped falling out, so now I just have a shaved head of stubble. It's a little patchy, and VERY cold (I had no idea how much heat my hair was holding in), so I supplement with some awesome wigs my cousin gave me and a few hats to keep warm.

A Letter to My CrossFit People
Note: I'm writing this about CrossFit, but generally speaking, you could substitute the idea of fitness throughout, so you can read this even if you don't do CrossFit. Or you could try CrossFit because it's awesome. 

As I was sitting at the chemotherapy infusion center on Tuesday for my third round of chemotherapy (out of 8 total), I was browsing through pictures of some amazing athletes at CrossFit Timpanogos, and I was inspired to write you a little note. Some of you have seen me there recently, after I finally got clearance from the reconstructive surgeon to go back to working out and lifting weights, albeit lighter weights than before (as an added bonus, I've gotten to make some new friends when I do the Fitness WODs instead of Performance). It has been great to be back, even if I am a little out of shape.

When we talk about CrossFit, we often say that it prepares you for "the unknown and the unknowable", and as I was sitting through the chemotherapy infusion, it made me think about how completely out of the blue (the very manifestation of unknown and unknowable) this cancer diagnosis has been.

At the same time, I realized how much CrossFit has done for me to prepare me for this challenge. I can honestly say that I am a different person now than when I first walked into Cache Valley Strength & Conditioning four years ago, and CrossFit Timpanogos 3-1/2 years ago. The workouts that we do every day have not only made me physically strong (which I believe is helping me get through chemotherapy and all these surgeries a little easier), they have made me mentally tough too. The ability to power through a CrossFit WOD, your whole body screaming at you to please stop, then to find the strength to keep pushing through until you have accomplished your goal is a a tremendous benefit in this fight with cancer or any challenge in life.

Plus the people at CrossFit Timpanogos, and friends from other gyms, have provided me with much-needed emotional support through this whole ordeal, like a cheerleading squad behind me the whole time. The highlight of my days is walking into the gym to see all your smiling faces (even if those smiles do turn to agony-filled faces as the WOD progresses), to get hugs and words of encouragement, to hear how you are doing, and to hear your inspiring stories of you and your loved ones who are survivors just like me.

I have also been thinking about some of you who I haven't seen at CrossFit in a while (I won't name any names, although some of you have personally confessed to me that you've been slacking lately, so you know who you are). I can totally sympathize with you on how easy it can be to fall into a habit of not showing up at the gym, and maybe it is even for very valid reasons. But the reality is that there are so many things that you are getting when you DO show up for the workouts, whether it's achieving your goal of losing weight and getting healthier, being able to chase your kids around at the park instead of being out of breath the whole time, or even being strong enough to get through a fight with a disease like cancer or another big challenge in your life.

If you haven't been to a WOD in a while, I challenge you to join me back at the gym. Don't wait for the new year to come back (believe me, there's nothing magical about the date of January 1 that is going to change your motivation level). Come back today. Or tomorrow. Or the next day. Just come back. If it seems hard, just think about how much I want to see you there, and how much I miss you. Not just me either--I think I could speak for all the coaches and your fellow CrossFitters when I say that we all miss you.

I truly love all of you, and appreciate the support and encouragement you provide me with every day. I look forward to seeing you at the gym soon!

P.S. If you're reading this and you don't go to CrossFit, (1) what is wrong with you? It's the best workout you will ever get in your life, so you should join, and (2) feel free to join us any time at CrossFit Timpanogos in Lehi. Your first 3 classes are free!

Chemotherapy and You

When I first met with the oncologist in October, they gave me a booklet entitled "Chemotherapy and You," which included several pages explaining the most common side effects of having poisonous toxins pumped into your body over the course of several weeks and months. While it is a helpful piece of literature to anticipate some of the changes that might come, both the book and the oncologist continually emphasize that every person responds differently to chemotherapy, which means the book on "chemotherapy and me" can't really be accurately written until I am done with the treatments.

Round 1: November 19

I've never been the type of person who was nervous about new situations, but my first day of chemotherapy was definitely a mix of emotions. All the delays caused by the difficulty with getting my mastectomy incision healed meant that chemo had been put off almost a month from the original start date. It had been a while since I first met with the oncologist, and while I was not exactly excited to get this thing going, I was definitely ready to get it over with. At the same time I was very nervous about what was about to come. 

The day began simply enough with some lab work, to make sure I was in good enough condition for my first treatment (meaning my white blood cell count was high enough to withstand the onslaught of drugs coming my way without increased risk of infection). The doctor said my white blood cell count was exceptional, so we could go forward.

The next couple of hours were actually fairly relaxing--the Huntsman Cancer Center has a really nice infusion center where they have several pods that include four sections, each one complete with a recliner for the patient, another chair for a friend or family member, a couple of small desks, and even your own television with a blu-ray player. The view is also beautiful, overlooking the whole Salt Lake valley. Since my only experience with chemotherapy prior to this was basically Breaking Bad and the movie 50/50, I was expecting a small room with a few recliners placed in a semi-circle where I would have to stare awkwardly at people much older than me while we all got our bi-weekly dose of poison.

We also learned that on Tuesdays they show movies on a projector screen that covers the big windows, but apparently they only show educational stuff, so it's like the movies you had to watch in 8th grade when the teacher was out and you had a substitute. It's no Man of Steel, but I guess that has the effect of helping you sleep through your chemotherapy if you prefer.

The first four treatments will all be the same, beginning with the anti-nausea medication Dexamethasone. Once that's done dripping in, the nurse injects the Doxorubicin by hand, which comes in three small vials that have to be slowly injected over the course of 5-10 minutes (it begs the question, why can't they just get bigger vials, then only have to inject one over the course of 20-30 minutes?). Then we finish up with the Cytoxan, which takes about an hour to drip in through the IV. Overall it's about 2 to 2.5 hours, which isn't really that bad.

The Fun Part
Getting the actual chemo infusion is kind of the easy part--the really fun part is figuring out what it will do to you once you have the drugs in your system. As mentioned in my previous post, there is a laundry list of potential side effects, and in the grand scheme of things, I was actually pretty lucky. I did have a little bit of nausea that was pretty well controlled with all the anti-nausea meds they gave me, and aside from that the only major side effect was fatigue. I felt more tired and slept more than usual, but only a couple of hours more each night, which was kind of great.

I also had to go and get a shot of Neulasta at the University of Utah Daybreak Clinic the next day, and they mentioned that I might have some "bone pain" following the shot. I didn't know what that meant at the time, but on Saturday night I discovered that it feels kind of like you have bruises everywhere on your body, especially in areas where you have large bones, like your hips, shoulders, sternum, and femurs. Fortunately I took a Lortab and fell asleep on Saturday night to find that it was gone by Sunday.

I was also able to go back to work (although not all 40 hours), and even got to go back to CrossFit Timpanogos for the first time in 8 weeks. I loved it, even if I did kind of feel like I was on the verge of death after getting so out of shape in the past two months. With two weeks behind me, now it's time to find out what Round 2 would bring.